Nearly a week after submitting tests for Covid-19, a medical practice in North Carolina was still waiting for the results. New York City health-care facilities were told to only test people who are already hospitalized. A clinic in Oakland, California, has been conserving scarce supplies and turned away symptomatic patients who just a week earlier would have been tested.

These are the realities in the U.S., and they’re worlds apart from the Trump administration’s picture of millions of tests speedily processed by thousands of labs. The president boasted Wednesday that U.S testing topped any other country “by far.” Vice President Mike Pence said 552,000 tests have been performed as of Thursday morning.

But in fact, U.S. testing rates lag far behind on a per-capita basis. That’s likely to cost lives. South Korea, with less than a fifth the U.S. population, comes second in numbers tested, a fact that many cite to explain why it’s been able to rein in the disease’s spread. Germany’s aggressive testing has allowed the country to contain clusters of infections and keep its mortality rate to 0.5%, rate lower than elsewhere in Europe, even though it has the third-highest number of cases on the continent.


Mass testing would help health-care experts understand the scope of the pandemic. It could pinpoint which parts of the country are healthy enough to get back to work, reducing the damage to the economy. It would also help strapped health-care workers triage patients and better allocate dwindling resources. The U.S. has made progress in recent weeks as commercial labs and hospitals have gotten their testing up and running. The FDA has also increasingly cleared new, high-volume testing systems and more applications are coming in — Abbott Laboratories sought approval Thursday for a test that could give results in 15 minutes, according to Pence. But it’s not been enough to meet surging need.

Hospitals and doctors are now able to get tests but results are still slow to arrive, causing health-care facilities to burn through protective equipment like masks because they have to assume anyone tested has the virus until they know otherwise. Commercial laboratories, which do most of the testing, say they are bumping the sickest patients and symptomatic health-care workers to the front of the line, similar to actions taken in hotspots like New York City. While that should conserve protective equipment, it’s at odds with Trump’s goal of getting people back to work quickly.

Testing only the sickest impedes public health priorities like prevention, says Gary Miller, vice dean for research strategy and innovation at Columbia University’s Mailman School of Public Health.

“We don’t want people to end up in the ICU, or to be on ventilators,” he said.

At commercial lab giant Quest Diagnostics Inc., all 12 U.S. testing facilities are running around the clock. The company says it’s handled 44% of the 338,000 Covid-19 tests completed by commercial labs as of Wednesday. Even though it began planning weeks ago and has several of high-capacity Roche Holding AG diagnostics machines recently cleared by the FDA, Quest labs can’t keep up with demand and results take up to five days.

“It’s not okay to wait a week but that’s the reality,” says Quest spokesman Gary Samuels.

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